Thursday, May 15, 2008

Lazy NHS doctor nearly kills little girl

No diagnostic tests for peasants! Just take an aspirin. She's half blind now but the doctor will suffer no consequences. And what nobody is mentioning is WHY TB has resurfaced in Britain: "Refugees" from Africa bring it with them. Being kind to such refugees has sent a little British girl half blind

For three days, Katie Roberts lay unresponsive on a paediatric ward. The two-year-old's eyes were shut, her face sallow, and the drips taped to her arms only accentuated her wasted limbs. Katie had been ill for nearly a month with a high temperature, sickness and weight loss which her GP had repeatedly blamed on a virus. "It all started when Katie developed a slight temperature and came out in a rash,' says her mother Sarah, 27, from Grantham, Lincs. "The GP diagnosed mild chickenpox. But a week later, Katie had a high temperature and was vomiting. The weight fell off her. "The doctor's answer was always the same - it was a virus. I remember sitting in my car after yet another appointment, in floods of tears and so frustrated," recalls the auxiliary nurse. "My child was dying and no one cared. No one took her temperature, let alone did blood tests."

After three weeks, in desperation, Sarah and her husband Martin, 27, took Katie to A&E at Grantham Hospital. Katie was immediately transferred to a specialist paediatric ward in Lincoln where she had a brain scan, a lumbar puncture to check for meningitis and dozens of blood tests. "Doctors suggested she had everything from chickenpox to cancer, but all tests came back negative," says Sarah. Despite being on large doses of antibiotics, Katie was showing no signs of recovery.

Three days later, a doctor asked if she'dcome into contact with anyone who had TB. That question probably saved her life. She had indeed been exposed - through her aunt's boyfriend, James. He had been diagnosed with pulmonary tuberculosis, TB of the lungs, 18 months earlier - although he never found out how he had contracted it. Before the era of antibiotics and vaccinations, tuberculosis was responsible for thousands of deaths in the UK every year. But while many think the disease had been eradicated, around 8,000 cases of TB are still reported in the UK every year, mostly in major cities (just last month, 30 pupils at a secondary school in Birmingham were diagnosed with TB). Not all tuberculosis is infectious, but pulmonary TB is.

Two weeks after James started his antibiotic treatment, he was no longer infectious. But it had taken four months to diagnose him, meaning he'd had the potential to infect others during that time. Katie was moved into isolation.

Doctors explained she could have TB meningitis, a complication caused when the bacteria - mycobacterium tuberculosis - migrates to the lining of the brain and forms When these abscesses burst, they create inflammation which puts pressure on the brain. Without antibiotics to combat the bacteria, and steroids to reduce the swelling - the consequences would be catastrophic. There was a serious risk of brain damage, sight or hearing loss and septicaemia, leading to loss of limbs - and if the infection got out of control, organ failure and death.

Although doctors weren't certain, no time could be wasted. Katie was started on four antibiotics specifically for the disease via a gastric tube. She was also given steroids to reduce the inflammation in her brain and blood was sent off for analysis. It was then a waiting game. Gradually, after a few days, her fevers lessened and she stayed awake for longer - the results of the tests confirmed she did have the disease.

As their daughter recovered, Sarah and Martin foundthemselves increasingly angry about the needlessness of their ordeal - and how the doctors' lack of awareness could have killed Katie. Since James's diagnosis of TB 18 months earlier, Sarah had been anxious that Katie could catch the disease. But her GP had insisted there was no risk, because James saw Katie only once a week, for a few hours.

According to the UK charity TB Alert, the doctor's reaction was typical, demonstrating the general lack of awareness among healthcare professionals. "Because tuberculosis has been dealt with so effectively in the past 50 years, many GPs, particularly those away from the high-risk areas such as London, will never have seen the disease," says Melanie Matthews, of TB Alert. "But it's on the increase, and as people travel can spread to socalled unaffected areas. There is also a complacency that it can be easily treated with antibiotics and is no longer dangerous. "In fact, for those who have weak immune systems, such as infants or elderly people, left untreated it can be fatal."

Another problem is that Government guidelines for screening those in contact with a sufferer are open to interpretation. The Department of Health makes it clear that the decision is down to individual clinics, while The National Institute for Clinical Excellence guidelines state that people who are in close contact with the TB sufferer should be tested and given precautionary antibiotics. Screening can be in the form of a blood test, a skin test or a chest X-ray. Katie had been exposed to active tuberculosis and was showing classic symptoms. Yet no one put the clues together until it was almost too late.

After three weeks, she was discharged from hospital, but was so weak she needed physiotherapy to build up her muscles. Fighting the disease is a long journey - Katie will take antibiotics for a year, until at least November this year. The family initially thought Katie might have got away unscathed, but this wasn't the case. Two weeks later, Katie was bumping into things or reaching out for a toy and missing it.

"The consultant ophthalmologist agreed Katie's sight was deteriorating, but felt it might be a repairable side-effect from one of the antibiotics," remembers Sarah. "We stopped giving her the drug but her sight kept deteriorating and a few days later she couldn't even see her hands. A scan confirmed the worst. "A few TB abscesses had swollen up again and were pushing onto the optic nerve - she was virtually blind. She was given 30mg of steroids a day to reduce the swelling." For two weeks, the family watched desperately for any sign of improvement, but her eyesight didn't improve. They were then warned their daughter's sight was unlikely to recover. "We were basically told to start organising our home around the needs of a blind child," says Sarah. "It all seemed so unfair. The one person I didn't blame was James. He'd done nothing wrong except become ill."

Unbeknown to the family, the consultant tracked down a doctor in Newcastle who'd had some success with a similar case by giving the child a huge short-term dose of steroids. "She called and said she wanted to double the dose from 30mgs to 60mgs a day," says Sarah. "We knew there might be side-effects such as liver damage and growth retardation, but if it saved her sight it would be worth it." And after three days, Katie's sight began to return. "To our relief, by the end of the two weeks it was back to 50 per cent of normal," recalls Sarah. Despite this, no one knows if Katie will have any long-term neurological damage. She has also gained weight from the high doses of steroids.

But having regained 50 per cent of her sight, Katie - who is now three-and-a-half - will be able to attend mainstream school and live a relatively normal life. "I hope that everyone who reads this realises the danger of underestimating TB," says Sarah. "It's on the increase and is not just confined to the inner cities or high-risk groups. And, as this story shows, it can still wreck lives."

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

Some TERMINOLOGY for non-British readers: The British "A Level" exam is roughly equivalent to a U.S. High School diploma. Rather confusingly, you can get As, Bs or Cs in your "A Level" results. Entrance to the better universities normally requires several As in your "A Levels".

Again for American readers: A "pensioner" is a retired person living on Social Security

Consensus. Margaret Thatcher in a 1981 speech: "For me, pragmatism is not enough. Nor is that fashionable word "consensus."... To me consensus seems to be the process of abandoning all beliefs, principles, values and policies in search of something in which no one believes, but to which no one objects—the process of avoiding the very issues that have to be solved, merely because you cannot get agreement on the way ahead. What great cause would have been fought and won under the banner "I stand for consensus"?

For my sins I have always loved G.B. Shaw's witty comment: "No Englishman can open his mouth without causing another Englishman to despise him". But Shaw was Irish, of course.

Britain has enormous claims to fame -- most of which the Labour goverment has been doing its best to destroy. But one glory no-one can destroy is British humour. And if you don't "get" British humour, your life is a dreary desert indeed. A superb sample here

Here is a link to my favourite British political speech since WWII. It is by Nigel Farage, the Leader of the UK Independence Party. He is referring to the Fascistic decision by the EU parliament to act as if their huge new "constitution" had been approved by the voters when in fact majorities in France, Ireland and Nederland (Holland) have rejected it at the ballot box. He points out that abuse is all they have to offer when he points out the impropriety of their actions.

Farage's expression, "A complete shower" is British slang meaning a group of completely incompetent and useless failures. It originated in the British armed forces where its unabbreviated version was "A complete shower of sh*t".

Britain appears to be the first country where anti-patriotism gained strong hold. Even Friedich Engels (the co-worker with Karl Marx who died in 1895) was a furious German patriot. Much of the British elite were anti-patriotic from the early 20th century onwards, however. The "Cambridge spies" (from one of Britain's two most prestigious universities) are a good example of that. Although Cambridge appears to have been the chief nest of spies-to-be in Britain of the 30s, however, Oxford was also very Leftist. In 1933 (9th Feb.) the Oxford Union debated the motion: "This House will in no circumstances fight for King and Country". The motion was overwhelmingly carried (275 to 153).

I have an abiding fascination with the Church of England. It is the sort of fascination one might have for a once-distinguished elderly relative who has gone bad and become a slave to the bottle. But nothing I can say about the C of E (which these days seems to stand for The Church of the Environment) could surpass what the whole of English literature says of it -- which ranges from seeing it as a collection of nincompoops and incompetents to seeing it as comprised of evil hypocrites. Yet its 39 "Articles of Religion" of 1562 are an abiding and eloquent statement of Protestant faith. But I guess that 1562 is a long time ago.

Links about antisemitism in 21st century Britain here and here and here

The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could well have been thinking of modern Britain when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the RD are still sending mailouts to my 1950s address

The kneejerk response of the Green/Left to people who challenge them is to say that the challenger is in the pay of "Big Oil", "Big Business", "Big Pharma", "Exxon-Mobil", "The Pioneer Fund" or some other entity that they see, in their childish way, as a boogeyman. So I think it might be useful for me to point out that I have NEVER received one cent from anybody by way of support for what I write. As a retired person, I live entirely on my own investments. I do not work for anybody and I am not beholden to anybody. And I have NO investments in oil companies, mining companies or "Big Pharma"

UPDATE: Despite my (statistical) aversion to mining stocks, I have recently bought a few shares in BHP -- the world's biggest miner, I gather. I run the grave risk of becoming a speaker of famous last words for saying this but I suspect that BHP is now so big as to be largely immune from the risks that plague most mining companies. I also know of no issue affecting BHP where my writings would have any relevance. The Left seem to have a visceral hatred of miners. I have never quite figured out why.

I am an army man. Although my service in the Australian army was chiefly noted for its un-notability, I DID join voluntarily in the Vietnam era, I DID reach the rank of Sergeant, and I DID volunteer for a posting in Vietnam. So I think I may be forgiven for saying something that most army men think but which most don't say because they think it is too obvious: The profession of arms is the noblest profession of all because it is the only profession where you offer to lay down your life in performing your duties. Our men fought so that people could say and think what they like but I myself always treat military men with great respect -- respect which in my view is simply their due.

Although I have been an atheist for all my adult life, I have no hesitation in saying that the single book which has influenced me most is the New Testament. And my Scripture blog will show that I know whereof I speak.

Many people hunger and thirst after righteousness. Some find it in the hatreds of the Left. Others find it in the love of Christ. I don't hunger and thirst after righteousness at all. I hunger and thirst after truth. How old-fashioned can you get?

My academic background

My full name is Dr. John Joseph RAY. I am a former university teacher aged 65 at the time of writing in 2009. I was born of Australian pioneer stock in 1943 at Innisfail in the State of Queensland in Australia. I trace my ancestry wholly to the British Isles. After an early education at Innisfail State Rural School and Cairns State High School, I taught myself for matriculation. I took my B.A. in Psychology from the University of Queensland in Brisbane. I then moved to Sydney (in New South Wales, Australia) and took my M.A. in psychology from the University of Sydney in 1969 and my Ph.D. from the School of Behavioural Sciences at Macquarie University in 1974. I first tutored in psychology at Macquarie University and then taught sociology at the University of NSW. My doctorate is in psychology but I taught mainly sociology in my 14 years as a university teacher. In High Schools I taught economics. I have taught in both traditional and "progressive" (low discipline) High Schools. Fuller biographical notes here

NOTE: The archives provided by blogspot below are rather inconvenient. They break each month up into small bits. If you want to scan whole months at a time, the backup archives will suit better. See here or here